Optimising service organisation for stroke patients

Background Stroke is the leading cause of long-term neurological disability in adults and the third most common cause of death in Britain. It is well known that in addition to the patient characteristics of age and severity, the treatment a stroke patient receives in hospital signifcantly affects outcome. The effectiveness of complex service interventions, how the benefits of these interventions are achieved and the economic impact of different types of service delivery were explored. Methods The Stroke Unit Trialists' Collaboration systematic review was updated and currently contains 31 clinical trials (6936 subjects). The aims were explored using various basic frequentist and Bayesian meta-analysis techniques as well as more complex meta-analysis ideas. These more complex ideas include: meta-regression where covariate information is incorporated into the model; and network meta-analysis where direct and indirect information is used in a mixed treatment comparisons model while also incorporating covariate information. Results Organised inpatient (stroke unit) care showed reductions in death, death or dependency and death or institutional care compared to general medical wards. Stroke unit care appears to reduce the risk of adverse outcomes through prevention and treatment of complications. Acute, comprehensive and rehabilitation stroke unit care appeared to be most effective and acute stroke unit care appeared to be the most cost-effective. However, acute followed by rehabilitation stroke unit care, if required, appears to be the most cost-effective pathway of care compared to the other pathways analysed. Discussion Future research should focus on rehabilitation, acute and comprehensive systems of inpatient care, and explore the best ways of preventing and managing specific complications. Effort should be made to make individual patient data and information on the care pathway of a stroke patient available for meta-analysis

Population Genetics of Bowhead Whales (Baleana mysticetus) in the Western Arctic

Bowhead whales (Balaena mysticetus) in the Bering, Chukchi, and Beaufort seas experienced a severe reduction as a result of commercial whaling in the 19th century. Since the cessation of commercial whaling, the population has recovered to a size that is approaching pre-whaling estimates. Inupiat and Yupik communities in northern and western Alaska hunt these Western Arctic (WA) bowheads along their migratory path during spring and fall. This hunting is regulated by the International Whaling Commission. Recent but preliminary analysis of available genetic data (207 whales and 10 microsatellite markers) raised the question of the presence of multiple, genetically distinct populations within the WA bowheads. Here we re-examined this question on the basis of a study of 414 whales and 22 newly developed microsatellite loci. We identified widespread departures from Hardy-Weinberg equilibrium; however, we were unable to detect significant evidence of multiple genetic populations within the WA bowheads that could explain this Hardy-Weinberg disequilibrium, particularly when compared to the strength of evidence for differentiation between WA bowheads and other populations from distant regions such as the Okhotsk Sea and eastern Canada. There was conclusive evidence of genetic differentiation among the three regions. The statistical rejection of panmixia within the WA improves our understanding of bowhead whale biology, and the lack of evidence for multiple populations within the WA enables risk-averse management of aboriginal hunting of Western Arctic bowhead whales.La population de baleines boréales (Balaena mysticetus) des mers de Béring, de Tchoukotka et de Beaufort a enregistré un grave déclin en raison de la pêche commerciale à la baleine au XIXe siècle. Depuis que la pêche commerciale à la baleine a cessé, la population de baleines boréales a connu un certain essor au point où elle approche maintenant les estimations de la taille qu’elle avait avant la pêche commerciale à la baleine. Les collectivités Inupiat et Yupik du nord et de l’ouest de l’Alaska chassent les baleines boréales de l’ouest de l’Arctique le long de leur voie de migration au printemps et à l’automne. La chasse est réglementée par l’International Whaling Commission. Des analyses récentes, bien que préliminaires, des données génétiques disponibles (207 baleines et 10 marqueurs microsatellites) ont soulevé la question de la présence de multiples populations génétiquement distinctes au sein de la population de baleines boréales de l’ouest de l’Alaska. Ici, nous avons réexaminé cette question en fonction de l’étude de 414 baleines et de 22 locis microsatellites nouvellement mis au point. Nous avons remarqué d’importantes déviations de l’équilibre de Hardy-Weinberg; toutefois, nous n’avons pas pu trouver de preuve significative de populations génétiques multiples au sein des baleines boréales de l’ouest de l’Alaska qui pourrait expliquer ce déséquilibre de Hardy-Weinberg, plus particulièrement en comparaison avec la force de la preuve de différenciation entre les baleines boréales de l’ouest de l’Arctique et d’autres populations de régions distantes telles que la mer d’Okhotsk et l’est du Canada. Il y avait des preuves concluantes de différenciation génétique entre les trois régions. Le rejet statistique de la panmixie au sein de l’ouest de l’Arctique améliore notre compréhension de la biologie des baleines boréales, et le manque de preuves de populations multiples dans l’ouest de l’Arctique donne lieu à la gestion de l’aversion au risque de la chasse à la baleine boréale de l’ouest de l’Arctique par les Autochtones

The importance of comprehensive parameter sampling and multiple observations for robust constraint of aerosol radiative forcing

© 2018 Author(s). Observational constraint of simulated aerosol and cloud properties is an essential part of building trustworthy climate models for calculating aerosol radiative forcing. Models are usually tuned to achieve good agreement with observations, but tuning produces just one of many potential variants of a model, so the model uncertainty cannot be determined. Here we estimate the uncertainty in aerosol effective radiative forcing (ERF) in a tuned climate model by constraining 4 million variants of the HadGEM3-UKCA aerosol-climate model to match nine common observations (top-of-atmosphere shortwave flux, aerosol optical depth, PM2.5, cloud condensation nuclei at 0.2% supersaturation (CCN0.2), and concentrations of sulfate, black carbon and organic carbon, as well as decadal trends in aerosol optical depth and surface shortwave radiation.) The model uncertainty is calculated by using a perturbed parameter ensemble that samples 27 uncertainties in both the aerosol model and the physical climate model, and we use synthetic observations generated from the model itself to determine the potential of each observational type to constrain this uncertainty. Focusing over Europe in July, we show that the aerosol ERF uncertainty can be reduced by about 30% by constraining it to the nine observations, demonstrating that producing climate models with an observationally plausible base state can contribute to narrowing the uncertainty in aerosol ERF. However, the uncertainty in the aerosol ERF after observational constraint is large compared to the typical spread of a multi-model ensemble. Our results therefore raise questions about whether the underlying multi-model uncertainty would be larger if similar approaches as adopted here were applied more widely. The approach presented in this study could be used to identify the most effective observations for model constraint. It is hoped that aerosol ERF uncertainty can be further reduced by introducing process-related constraints; however, any such results will be robust only if the enormous number of potential model variants is explored

Pre-M Phase-promoting Factor Associates with Annulate Lamellae in Xenopus Oocytes and Egg Extracts

We have used complementary biochemical and in vivo approaches to study the compartmentalization of M phase-promoting factor (MPF) in prophase Xenopus eggs and oocytes. We first examined the distribution of MPF (Cdc2/CyclinB2) and membranous organelles in high-speed extracts of Xenopus eggs made during mitotic prophase. These extracts were found to lack mitochondria, Golgi membranes, and most endoplasmic reticulum (ER) but to contain the bulk of the pre-MPF pool. This pre-MPF could be pelleted by further centrifugation along with components necessary to activate it. On activation, Cdc2/CyclinB2 moved into the soluble fraction. Electron microscopy and Western blot analysis showed that the pre-MPF pellet contained a specific ER subdomain comprising "annulate lamellae" (AL): stacked ER membranes highly enriched in nuclear pores. Colocalization of pre-MPF with AL was demonstrated by anti-CyclinB2 immunofluorescence in prophase oocytes, in which AL are positioned close to the vegetal surface. Green fluorescent protein-CyclinB2 expressed in oocytes also localized at AL. These data suggest that inactive MPF associates with nuclear envelope components just before activation. This association may explain why nuclei and centrosomes stimulate MPF activation and provide a mechanism for targeting of MPF to some of its key substrates

Anomalous Heat Conduction and Anomalous Diffusion in Low Dimensional Nanoscale Systems

Thermal transport is an important energy transfer process in nature. Phonon is the major energy carrier for heat in semiconductor and dielectric materials. In analogy to Ohm's law for electrical conductivity, Fourier's law is a fundamental rule of heat transfer in solids. It states that the thermal conductivity is independent of sample scale and geometry. Although Fourier's law has received great success in describing macroscopic thermal transport in the past two hundreds years, its validity in low dimensional systems is still an open question. Here we give a brief review of the recent developments in experimental, theoretical and numerical studies of heat transport in low dimensional systems, include lattice models, nanowires, nanotubes and graphenes. We will demonstrate that the phonon transports in low dimensional systems super-diffusively, which leads to a size dependent thermal conductivity. In other words, Fourier's law is breakdown in low dimensional structures

Recovered memories, satanic abuse, Dissociative Identity Disorder and false memories in the UK: a survey of Clinical Psychologists and Hypnotherapists

An online survey was conducted to examine psychological therapists’ experiences of, and beliefs about, cases of recovered memory, satanic / ritualistic abuse, Multiple Personality Disorder / Dissociative Identity Disorder, and false memory. Chartered Clinical Psychologists (n=183) and Hypnotherapists (n=119) responded. In terms of their experiences, Chartered Clinical Psychologists reported seeing more cases of satanic / ritualistic abuse compared to Hypnotherapists who, in turn, reported encountering more cases of childhood sexual abuse recovered for the first time in therapy, and more cases of suspected false memory. Chartered Clinical Psychologists were more likely to rate the essential accuracy of reports of satanic / ritualistic abuse as higher than Hypnotherapists. Belief in the accuracy of satanic / ritualistic abuse and Multiple Personality Disorder / Dissociative Identity Disorder reports correlated negatively with the belief that false memories were possible

Solar parameters for modeling interplanetary background

The goal of the Fully Online Datacenter of Ultraviolet Emissions (FONDUE) Working Team of the International Space Science Institute in Bern, Switzerland, was to establish a common calibration of various UV and EUV heliospheric observations, both spectroscopic and photometric. Realization of this goal required an up-to-date model of spatial distribution of neutral interstellar hydrogen in the heliosphere, and to that end, a credible model of the radiation pressure and ionization processes was needed. This chapter describes the solar factors shaping the distribution of neutral interstellar H in the heliosphere. Presented are the solar Lyman-alpha flux and the solar Lyman-alpha resonant radiation pressure force acting on neutral H atoms in the heliosphere, solar EUV radiation and the photoionization of heliospheric hydrogen, and their evolution in time and the still hypothetical variation with heliolatitude. Further, solar wind and its evolution with solar activity is presented in the context of the charge exchange ionization of heliospheric hydrogen, and in the context of dynamic pressure variations. Also the electron ionization and its variation with time, heliolatitude, and solar distance is presented. After a review of all of those topics, we present an interim model of solar wind and the other solar factors based on up-to-date in situ and remote sensing observations of solar wind. Results of this effort will further be utilised to improve on the model of solar wind evolution, which will be an invaluable asset in all heliospheric measurements, including, among others, the observations of Energetic Neutral Atoms by the Interstellar Boundary Explorer (IBEX).Comment: Chapter 2 in the planned "Cross-Calibration of Past and Present Far UV Spectra of Solar System Objects and the Heliosphere", ISSI Scientific Report No 12, ed. R.M. Bonnet, E. Quemerais, M. Snow, Springe

Perspectives in visual imaging for marine biology and ecology: from acquisition to understanding

Durden J, Schoening T, Althaus F, et al. Perspectives in Visual Imaging for Marine Biology and Ecology: From Acquisition to Understanding. In: Hughes RN, Hughes DJ, Smith IP, Dale AC, eds. Oceanography and Marine Biology: An Annual Review. 54. Boca Raton: CRC Press; 2016: 1-72

RANTES/CCL5 and risk for coronary events: Results from the MONICA/KORA Augsburg case-cohort, Athero-express and CARDIoGRAM studies

Background: The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events. Methods and Findings: We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±